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Anybody can list what they do by reading off a series of bullets that represent capabilities. But what’s behind the what? It’s the How that makes the difference. Take a look at How Corporate Synergies does it.

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Natural disasters, cyber attacks and human error place businesses in the crosshairs every day. Corporate Synergies provides one-stop insurance and risk mitigation consulting across a variety of industries.

Popular HDHPs Create Plenty of Challenges for Employees

Although HDHPs have been around a while, they can still cause out-of-pocket sticker shock.

Most employers have dipped their toes in the high-deductible health plan (HDHP) waters, either because they’ve implemented a plan or because they’ve considered it as part of their benefit offerings; 29% of covered workers are enrolled in HDHPs with savings options, up from 4% in 2006.1

The goals of implementing this type of medical savings plan are twofold. First, these plans usually provide a much-needed premium savings. Second, HDHPs are designed to encourage consumerism and motivate employees to make more cost-conscious choices. For example, using urgent care over the emergency room when appropriate.

Unintended Consequences

Unfortunately, high deductible health plans may also have some unintended consequences. Think about the employee who is struggling financially and perhaps even living paycheck to paycheck. Facing the reality of plunking down $100-$200 or more for a sick visit at the primary care doctor’s office or urgent care facility may preclude them from seeking care.

An untreated illness could become more severe and potentially lead to a hospitalization and lost productivity due to additional time off from work. Then of course, there is the sticker shock that often accompanies the visit to the pharmacy.

Prior to HDHPs, who noticed the actual cost printed on a prescription label?

Paying a $15 or $20 copay is no big deal. But with an HDHP, the employee may choose not to fill the prescription at all, including medications to manage chronic conditions.

Impact on Health & Wellness Programs

Health & wellness programs are often offered as a complement to HDHPs. Encouraging preventive care is frequently a core component of a disease management and wellness program. However, sometimes employees forget that preventive services are included in the health & welfare benefits plan without any associated out-of-pocket costs.

Assuming the provisions of the Affordable Care Act (ACA) remain in place at least for the foreseeable future, adult annual physicals and age-appropriate screenings, such as mammography and the dreaded colonoscopy, are covered in full as long as the employee uses an in-network provider. When feasible, an employer may also consider adding a prescription drug tier with zero copay for certain maintenance medications, thereby eliminating the financial barrier and allowing employees to better manage their chronic conditions.

Budgeting for Medical Expenses

So, how can employers help plan participants manage the financial equation of HDHPs that are clearly here to stay? One suggestion is to propose they prepare a medical expense budget (i.e., quarterly sick visits to primary care physicians, cost of maintenance medication, etc.). Providing a worksheet to estimate annual out-of-pocket expenses can be helpful, perhaps with common examples included.

Some employers partially fund the deductible with a contribution to a health savings account (HSA). When possible, the employee should consider allocating a portion of their pay toward the remaining deductible amount. This will ease the worry of not having funds to cover the deductible, and any unused funds rollover. By contributing to an HSA, the employee gets an immediate tax savings and builds up a fund to use as needed. In the event there is a medical expense that exceeds the balance in the account, encourage employees to request a payment plan equal to their HSA contribution. When the contribution goes in, they can then make the payment. Most medical providers are open to these types of arrangements. Consider a communications campaign to explain the functions of an HSA.

Encourage Employees to Become Educated Consumers

Employees are generally not thinking about their health & welfare benefits every day and need to be reminded of the value of becoming an educated consumer when they do use their benefits. Direct employees to carrier cost estimator tools for everything from MRIs to prescription drug costs. Many carrier websites provide instructional videos to demonstrate how these features work. Send the links out on a proactive basis or consider offering a healthy lunch-and-learn to discuss these resources.

Lower-Cost Healthcare Options

With any health plan there are a number of ways to save money. Encourage employees to use lower-cost healthcare options such as:

Generic drugs over brand-name when possible

Mail-order prescriptions for management drugs

In-network/preferred providers versus out-of-network

Telemedicine, if available

Take the opportunity to remind employees about these lower-cost healthcare options frequently.

Leverage Employee Advocacy

Even with the best efforts to educate employees, it may be difficult for them to absorb all the information. Direct employees to an employee advocacy team if it’s available. These experienced health & welfare benefits professionals can assist with research and provide meaningful suggestions to help employees get the most out of their plan for the least cost.

Managing medical costs will likely remain a challenge for both employers and employees so it is important to stay informed as new cost transparency tools become available and to constantly educate employees so they can make informed choices that are also affordable for them.

Did you know there is an alternative to paying State Unemployment Taxes that saves non-profits thousands? Think of it as a $50,000 donor walking through your door! Hear from 3 unemployment insurance experts.

The last few months have provided a whirlwind of activity around the ACA. Even though the ACA replacement bill failed to go to vote in the House, discussions & debates continue. For now, the ACA remains law, yet it is evolving. Some parts of the ACA will likely be transformed while other parts will likely die.

What will it mean for you? ERISA attorney and Healthcare Reform expert Dan Kuperstein will provide the legal interpretation and street-level guidance you need, including:

What went wrong with the repeal and replace initiative

The leading replacement plan – the AHCA

Compliance with the surviving ACA in 2017, its evolution and challenges

Why medical carriers are adding telemedicine to most fully-insured contracts

How telemedicine impacts claims for self-funded plans and how employees can benefit too

How education drives employee participation and understanding of what telemedicine can and cannot do

FMLA Law, Paid Leave & Upcoming Changes for NY Employers

Unum will present and discuss:

Family and Medical Leave Act (FMLA), including legal considerations for employers & risk of non-compliance

Administrative options & employer challenges with FMLA programs, as well as the link between FMLA and Short-term Disability programs

Potential ROI for administering & managing FMLA with Short-term Disability in a single administrative platform

The value of developing a more structured FMLA administration program

Upcoming 2018 New York Paid Family Leave Law

Lower Healthcare Costs up to 30% with Reference-based Pricing

Historically we’ve asked providers how much they need to perform a service, procedure or treat a medical condition, then we would negotiate a lower rate by promising more patients. But has that approach promoted less personalized service and a need for physicians to increase service volume? Did we trade quality for quantity? In this session, you will:

Understand the current billing system, negotiated discounts and allowed charges

Learn reference (or “metric-based”) pricing by calculating costs from a measurable price, rather than starting with a fictitious cost of service pricing system

Appreciate pitfalls and challenges in referenced-based pricing

Hear how conversations about fair pay to providers is taking place at every level, from government to individual providers

FMLA continues to be a top concern for HR, while the ADA has been called an “inadvertent leave act.” In this session, leave management expert Mike Garfield walks through complexities of both FMLA and ADA, trends in absences, and solutions for employers wishing to reduce impact to their organization. Attendees will learn:

Top trends in absences related to FMLA and ADA

Key questions to ask when considering outsourcing leave management

How to integrate other support programs to speed employee return to work

SUI Tax Relief for Nonprofits

ALERT: There is an alternative to paying State Unemployment Taxes that saves nonprofits thousands! Think of it as a $50,000 donor walking through your door. Unemployment insurance expert Ron Lucki from UC Assure explains.

Healthcare costs continue to push upward. This trend poses a significant financial challenge for employers in 2017 and in the years to come. Bill Resnick, Chairman and CEO, and Kristin Begley, Chief Revenue Officer of Pharmacy Benefits Manager EmpiRx Health, walk employers through the role of the PBM in the design of drug plans that manage spending while providing clinical care commensurate with patient need.

They discuss:

Inflationary factors impacting drug programs

The role of rebates, tradition pricing and pass-through pricing

New drugs entering the market place

Specialty drugs’ impact on escalating cost…and how to manage the trend